Knock-knees
Knock-knees, also known as genu valgum, is a condition characterized by the knees being positioned close together while the feet remain apart when standing. This deformity can occur in both children and adults, with common causes in infants being a normal developmental phase as their legs straighten from a previously bowlegged position. In older individuals, knock-knees may arise due to factors such as infections, obesity, or leg fractures that disrupt normal bone growth. Symptoms include altered knee positioning, an imbalanced center of gravity, and in some cases, movement difficulties or arthritis.
Most cases of knock-knees in children resolve naturally without treatment, as growth often corrects the alignment. Medical attention is generally only necessary if the condition is severe, painful, or affects mobility. Treatments may include physical therapy, stretching exercises, orthopedic braces, or, in more serious instances, surgical intervention. Historically, various braces and fixators were used to address the condition, but contemporary medical practice often emphasizes allowing natural correction, especially in typical developmental cases. Understanding knock-knees is important for recognizing both its commonality in childhood and potential underlying health issues in adults.
Knock-knees
ALSO KNOWN AS: Genu valgum
ANATOMY OR SYSTEM AFFECTED: Bones, feet, hips, joints, knees, legs, ligaments, muscles
DEFINITION: A deformity in which the knees are positioned close together or turn toward each other and the tibias and ankles are apart when the feet are placed in a normal standing position.
CAUSES: Normal condition in infants; infections, obesity, or fractures in older individuals
SYMPTOMS: Altered knee positioning, imbalanced center of gravity, sometimes arthritis
DURATION: Usually temporary
TREATMENTS: None, unless pain develops or movement is impeded; may include stretching, shoe inserts, physical therapy, orthopedic braces, surgery
Causes and Symptoms
Knock-knees, affecting both knees or occasionally only one, are a normal condition as children mature. Infants’ leg are slightly rotated because of uterine positioning. As toddlers’ legs straighten after having bowlegs, their tibias and knees often temporarily rotate toward the body’s axis, causing the feet to be several inches apart. When knock-knees are not representative of normal physical development, they occur because of health conditions such as infections, obesity, or fractured legs that disrupt growth. Knock-knees are sometimes a symptom of other conditions.
Mobility may be affected with knock-knees. Patients sometimes adjust leg and foot movement to compensate for altered knee positioning and imbalanced centers of gravity. Usually, children walk with their toes turned in for balance when they have knock-knees. Knock-kneed adults sometimes develop because of the on knee joints and ligaments. Knock-knees can also place stress on patients’ backs and hips.
Treatment and Therapy
Medical professionals do not treat most knock-knees unless specific cases seem abnormal, cause pain, or impede movement. Growth usually corrects knee positioning. Physicians measure legs and the distance between ankles to assess the progress of natural correction. X-rays are useful to detect bone problems that may exacerbate knock-knees. Photographs can document leg alignment.
Stretching the leg muscles can aid the natural resolution of knock-knees. Shoes designed with inserts can mitigate the stress on feet and manipulate patients to walk straight. Physical therapy can alleviate and joint pain associated with knock-knees.
If young patients do not outgrow knock-knees, ankle distances increase to four inches or more, or the condition worsens, particularly in one knee, then medical intervention often becomes necessary to ensure that patients are capable of normal movement. Physicians sometimes advise patients to wear a brace. If such efforts are unsuccessful, then the patient may undergo surgery to adjust leg bones and growth plates.
Treatment is essential for diseases or conditions in which knock-knees is a symptom. Some patients seek medical correction for aesthetic reasons.
Perspective and Prospects
Beginning in the late nineteenth century, physicians routinely recommended therapeutic braces to treat knock-knees. During the 1950s, Soviet doctor Gavril Abramovich Ilizarov devised a fixator that encircles legs and uses tension to correct rotation problems associated with knock-knees. Italian doctor Antonio Bianchi-Maiocchi first used this device in Western countries in 1981. James Aronson brought the method to the United States in the 1980s. In that decade, Ukrainian doctor Veklich Vitaliy adapted Ilizarov’s fixator for a procedure that is often used to correct severe knock-knees.
By the late twentieth century, however, physicians discouraged the use of braces to treat normal cases of knock-knees. Most advised patients to permit natural correction to occur, emphasizing that devices would not quicken that process.
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